Facet joints are small flat joints located at the back (posterior aspect) of the spine between adjacent vertebrae.   Unlike the discs which are large and transmit force and body weight the facet joints act to control movement at different levels of the spine.  The may be thought as “guide rail joints”.   In the lower back (lumbar spine) the facet joints and arranged vertically and therefore allow flexion and extension (bending forwards and backwards) and lateral flexion (bending to the side).  The vertical alignment restricts rotation in the lumbar spine and therefore helps reduce rotational forces on the lumbar discs.  Each joint is surrounded by a small capsule and contains a lubricating nourishing liquid called synovial fluid.

Facet joints are a common source of back pain.  An episode of pain may be due to a sudden traumatic movement which injures the joint or long term repetitive strain resulting from poor posture and inefficient body use.  Injury creates an inflammatory reaction in the joint resulting in facet joint pain and swelling.  Long term pain may be the result of excessive force passing through the joint causing facet joint inflammation or actual roughening of the joint surfaces i.e. arthritic change.

Facet Joint Syndrome Symptoms

Facet Joint Syndrome Symptoms can be caused either by a sudden traumatic movement or occur for no apparent reason due to repetitive strain.

• Pain is typically located on one side of the spine and can be both dull and sharp in character.  The pain level can be high.
• Pain may radiate (spread) into the buttock and leg.  If the adjacent nerve roots are irritated a sharp electric shock type pain may shoot into to the buttock, leg or groin.
• Muscle spasm is common in the adjacent muscles to the joint.
• Facet Joint Back Pain is usually worse in the morning for up to 30 minutes and is aggravated by
  • Side bending toward the affected side
  • Extending the spine (backward bending).
  • Changing position – standing up, sitting down, turning in bed
• Facet Joint Back Pain Relief via
  • Staying still
  • Lying down

What you can do

• Rest
• Take anti inflammatory medication  -  speak to doctor or pharmacist about a suitable product
• Ice therapy to reduce inflammation
• Heat to reduce muscle spasm.  Be careful with heat treatment – in the early stages heat may exacerbate inflammation and increase symptoms so use heat in small doses intitially.

Facet Joint Syndrome Treatment

• Osteopathic pumping techniques to remove facet joint inflammation from around the joint (foraminal gapping, reinforced flexion and traction)
• Spinal manipulation of affected joint to open up the facet joint and break down scar tissue formation that may restrict joint movement
• Massage to reduce muscle spasm
• Spinal manipulation and stretching to reduce mechanical load on affected area
• Postural advice and exercises to reduce mechanical load on affected joints

Further treatment options

• Corticosteroid injection into the facet joint to reduce inflammation.
• Radiofrequency denervation’. A technique that destroys the nerve supply to the joint using ionizing radiation

Tags: back pain, low back pain